Active NPI
Walter David Harris, M.D.
- Gynecology Physician
- Destin, FL
National Provider Identifier
1205126992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- ME47899
- Practice address
- 4485 Furling LN
Destin, FL 32541-5331 - Phone
- (850) 654-8015
- Fax
- (850) 654-3380
- NPI assigned
- Apr 14, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | ME47899 | FL | Primary |
Addresses
Primary practice location
4485 Furling LN
Destin, FL 32541-5331
Mailing address
4485 Furling LN
Destin, FL 32541-5331
Phone (850) 654-8015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME47899 | FL | MD | Gynecology Physician |
| ME47889 | FL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302739200000",
"number": "1205126992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4485 FURLING LN",
"city": "DESTIN",
"state": "FL",
"postal_code": "325415331",
"telephone_number": "850-654-8015",
"fax_number": "850-654-3380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4485 FURLING LN",
"city": "DESTIN",
"state": "FL",
"postal_code": "325415331",
"telephone_number": "850-654-8015",
"fax_number": "850-654-3380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "WALTER",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-14",
"last_updated": "2011-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "FL",
"license": "ME47899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Destin, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.